Comparison of Allergy Shots with Allergy Drops Chart

At the Northern Nevada Allergy Clinic, our aim is to get your symptoms under the best control possible, with the least amount of medication necessary. We don’t “push” one treatment option or another whether it’s allergy drops, shots, pills, creams, sprays, puffers/inhalers, or other therapies. You will have a complete and thorough evaluation by a fellowship-trained, board-certified Allergist, after which we will discuss the management options for your condition(s) and the relative benefits and risks of each. Working together, we will arrive at a management plan that is right for you.

Requires at least a 20-30 minute wait in the doctor’s office to monitor for reactions

No travel, no waiting; drops take seconds to administer and are held under the tongue for 60 seconds thereafter

Frequency

Initially, injections are given once or

twice a week for approximately 2 months (for rapid buildup schedules) or 3-6 months (standard buildup) to reach maintenance dose. Once at maintenance dose, shots are typically received once a week for another 6 months, before the interval is gradually increased to once every 2 to 4 weeks.

Once daily

Preventative affect

Reduces the chance of developing asthma and new allergic sensitizations.

Reduces the chance of developing asthma and new allergic sensitizations.

Long-term effect

Potential “cure” for allergy and asthma symptoms.

Potential “cure” for allergy and asthma symptoms.

Long-term benefit

In many patients, provides long-term benefit even after shots have been stopped, especially if taken for >3-5 years.

In many patients, provides long-term benefit even after drops have been stopped, especially if taken for >3-5 years.

Age requirement

Generally not used in children under 5-6 years old

May be used in younger children, in some studies even infants. Our current lower limit for age is approximately 3 years old, with adjustments for maturity.

Speed of results

Benefit often seen within a few weeks, but may take longer depending on how often shots are received. Therapy is taken year-round

Benefit often seen within a few weeks, other studies show benefit may take longer, often increasing as therapy is continued. Therapy is taken year-round.

FDA status

FDA approved therapy.

Uses the same FDA-approved extracts as allergy shots, but the route of administration (under the tongue) is not currently FDA approved. Therefore this method of administration is considered “off-label” at the present time.

History

Given for nearly 100 years both in the U.S. and in other countries.

Given for nearly as long as shots, but not as widely used until recently. In the last 7-10 years, use increased dramatically because of safety and convenience, and is now the primary route of immunotherapy for much of Europe and South/Central America, with increasing use in the U.S.

Benefits

Significantly reduces symptoms, and reduces the need for allergy and asthma medications.

Significantly reduces symptoms, and reduces the need for allergy and asthma medications.

Effectiveness

Appears in head-to-head trials to be the most effective route of administration.

Very effective, but may not be as effective as shots in some studies.

Risks

Risk of allergic reaction (anaphylaxis), and reason why administration in doctor’s office with a 20-30 minute wait is required. Even so, anaphylaxis occurs in approximately 1 in 200-500 injections (mostly mild to moderate, easily treated). Severe reactions are less common, but deaths do occur, with risk estimated at approximately 1 in 2.5 million

No reported severe life threatening reactions or deaths as of Jan 2008, with millions of doses administered.

Needles

Some adults and children are afraid of needles or think shots are painful. However, some people prefer shots because the therapy is given less frequently.

No needles. Drops placed directly in the mouth and held under the tongue for about a minute, then swallowed. Therapy is given every day.

Insurance

Covered by most insurance, but co-payments and deductibles apply. These may vary widely: between $0 - $160/month. Travel time and cost to go to doctor’s office for shots also needs to be taken into consideration.

Not covered by insurance, but cost is less than $20 a week. For many patients, out of pocket cost is equivalent or less than injections even though insurance does not cover.

No travel expenses or time away from work/school. Reduced expenditure on drugs can also be a significant cost-savings for many.

In travel

Allergy shots do not travel with you, but not receiving shots is usually not a problem for trips of a few weeks or less.

Drops travel easily with you anytime, anywhere, for any duration. Drops do not require refrigeration, and can also be easily carried onto an airplane.